Does Medicaid Cover Memory Care?

Medicaid does cover many costs associated with memory care, but it doesn’t automatically cover the cost of memory care in an assisted living environment. Medicaid is a health insurance program available to people on low incomes. Because it is administered by individual states, what’s covered and how it’s covered can differ greatly depending on where you live. It’s important to investigate the coverage in your area. Local Area Agencies on Aging are a good place to start when looking for this information.

There are several services covered by Medicaid in every state that could be useful for people with Alzheimer’s disease or dementia, including nursing home care and home health care.

All eligible Medicaid recipients have coverage for nursing home care. This includes people living in memory care or dementia units within a nursing home facility. However, there are strict medical eligibility requirements to obtain nursing home care. Generally, you have to need a high level of medical care to be eligible for skilled nursing care. In the early stages of the disease, those with dementia have more need for help with daily activities than specific medical services.

Home health care is also a mandatory Medicaid benefit. This provides skilled nursing services in the home. Again, this only covers medical services, but it can give you assistance if you’re caring for a family member with dementia. Using Medicaid to pay for this care can also free up funds to pay for other essential services.

States have different names for these programs and also offer varying benefits. However, in some states, some assisted living services are included in the benefits, and this generally includes memory care. Most states also cover in-home care. This provides nonmedical services, such as assistance with eating, bathing and other activities of daily living, that can help you remain living at home. It may also provide assistance with transportation, cooking and similar errands.